Formation of a Pellicle Forms on the tooth surface by selective adsorption of protein components from the saliva. Bacterial Multiplication and ColonizationMicrocolonies form in layers as the bacterial colonies multiply. Biofilm Growth and MaturationBiofilm grows as it is left undisturbed- the bacteria multiplies

Formation of Biofilm

Acquired Pellicle- Thin film of protein, only removed with coronal polish, reforms within minutes of removal.Biofilm- “Plaque” organized matrix of microorganisms.Materia Alba-Soft grayish-white mixture of bacteria, saliva protein, and usually food debris. Looks white and cottage cheese-like.Food debris- Particles of food that are left after eating

Types of Plaque and Other Soft Tooth Deposits

Plaque is a colorless, soft, sticky coating that adheres to the tooth. MS and LB live in the dental plaqueMay only be removed mechanically Flossing and ToothbrushingRinse with water or mouthrinse have no effect on plaque200-500 microorganisms live in 1gm. Of plaque.

Plaque and Dental CariesInfectious and communicableIntroductionA laser caries detector cannot be used to diagnose interproximal caries because of limited access to interproximal surfaces. When using a laser caries detector, a carious tooth will show more fluorescence, and a clean, healthy tooth will show less fluorescence. The laser caries detector is equally effective in both primary and permanent teeth. It cannot detect caries under dental sealants or an amalgam restoration, although it will detect decay around the occlusal margins of a restoration.Laser caries detectors work by passing a beam through the tooth surface. A clean, healthy tooth will have a baseline reading of 0.A DIAGNOdent reading of 15 to 20 indicates preventive therapy and sealants.A false-positive is possible if plaque or food particles are present in fissures; therefore it should not be used as the only diagnostic tool.

Laser Caries DetectionTooth decay is the single most prevalent disease of childhood.Causes dental pain and swelling the in the gums.#1 reasons for children to miss schoolMore common in families with low socioeconomic statusAlso common in special needs childrenBaby Bottle Tooth DecayEarly Childhood CariesMultiple lesions throughout the mouth.Associated with poor homecare and excessive/frequent intake of sucrose or xerostomiaMaybe frequent in childrenRampant CariesRoot cariesDemineralization begins, possibly maybe remineralized. The caries is less than ½ way through the enamel.Stages of Caries

Within 5 mins after eating/drinking bacteria converts the sugars into acid (the bacteria’s by-product from eating the sugar).The acid attacks the tooth, dissolves the calcium and phosphate from the enamel.When this process is left undisturbed, dental caries are formed.

Days 7-14Biofilm is not materia alba. White blood cells in body begin to increase, more gram-negative bacteria ,along with anaerobic organism, appear.

Days 7-21Vibrios and spirochetes are highly prevalent, gingivitis is clinically evident.

Changes in biofilm Microorganisms

Formation of BiofilmChanges in biolim MicroorganismsStages of Plaque FormationBacterial InfectionMay be passed from one person to another (ie: mother to child-a childs mouth is actually bacteria free at birth)Mutans Streptococci (MS) and Lactobaccilli (LB)Form around an existing restoration at the margins and/or interproximal areas.Maybe difficult to detect with dental explorer and radiographs.New restorative materials (Glass Ionomers) slowly release fluoride, reducing the risk of secondary caries development.

Formation of caries at gingival margin on the exposed root surface.Xerostomia increases the risk of root cariesAppearance: brown or blackPrevalent with the elderlyPeople living longerMore likely to have recessionTypically on medications which cause xerstomia

Saliva can neutralize the acid and mineral may assist with the replacement of lost tooth structure: calcium and phosphate in saliva, supplements of fluoride.Called RemineralizationDemineralizationRemineralizationIncipient lesionOvert or frank lesionCavitation of the tooth, must be repaired. The caries is over ½ way through the enamel.

Tooth DecayBaby Bottle Early childhood cariesBaby bottle syndromeDietLimiting snacksDo not sip soda all day, rinse with water after drink the soda, after your last sip of soda your mouth is at an acid level for 20 mins. SupplementsFluoridesOral HygieneXylotol gumMakes the tooth more resistant to demineralizationHelps prevent bacteria from adhering to the tooth.SalivaBrushing at least 2 times a day for 2 mins.Antibacterial rinsesFlossingNeutralizes the acidsPhysical ProtectionImmunoglobulins to work against bacteria.Chemical ProtectionContains calcium, phosphate, and fluoride (amount is dependant on fluoride supplements and water fluoridation)Antibacterial ProtectionDIAGNOdentMateria AlbaDental Biofilm